I’m a terrible sleeper, which is perhaps why I got invited to contribute to a NY Times group blog on “insomnia, sleep and the nocturnal life”. Here is my first contribution, which focuses on the work of Dan Wegner:

My insomnia always begins with me falling asleep. I’ve been reading the same paragraph for the last five minutes — the text is suddenly impossibly dense — and I can feel the book getting heavier and heavier in my hands. Gravity is tugging on my eyelids.

And then, just as my mind turns itself off, I twitch awake. I’m filled with disappointment. I was so close to a night of sweet nothingness, but now I’m back, eyes wide open in the dark. I dread the hours of boredom; I’m already worried about the tiredness of tomorrow.

Why did my brain wake itself up? What interrupted my slumber? To understand this frustrating mental process, let’s play a simple game with only one rule: Don’t think about white bears. You can think about anything else, but you can’t think about that. Ready? Take a deep breath, focus, and banish the animals from your head.

You just lost the game. Everyone does. As Dostoevsky observed in “Winter Notes on Summer Impressions”: “Try to avoid thinking of a white bear, and you will see that the cursed thing will come to mind every minute.” In fact, whenever we try not to think about something that something gets trapped in the mind, stuck in the recursive loop of self-consciousness. Our attempt at repression turns into an odd fixation.

This human frailty has profound consequences. Dan Wegner, a psychologist at Harvard, refers to the failure as an “ironic” mental process. Whenever we establish a mental goal — such as trying not to think about white bears, or sex, or a stressful event — the goal is accompanied by an inevitable follow-up thought, as the brain checks to see if we’re making progress. The end result, of course, is that we obsess over the one thing we’re trying to avoid. As Wegner notes, “The mind appears to search, unconsciously and automatically, for whatever thought, action, or emotion the person is trying to control. … This ironic monitoring process can actually create the mental contents for which it is searching.”

These ironic thoughts reveal an essential feature of the human mind, which is that it doesn’t just think: it constantly thinks about how it thinks. We’re insufferably self-aware, like some post-modern novel, so that the brain can’t go for more than a few seconds before it starts calling attention to itself. This even applies to thoughts we’re trying to avoid, which is why those white bears are so inescapable.

What does this have to do with sleep? For me, insomnia is my white bear. My conscious goal is to fall asleep, which then causes my unconscious to continually check up on whether or not I’m achieving my goal. And so, after passing out for 30 seconds, I’m woken up by my perverse brain. (Most animals lack such self-aware thoughts, which is why our pets never have trouble taking a nap.)

In a study published in 1996 in the journal of Behavior Research and Therapy, Wegner and colleagues investigated the ironic monitoring process in the context of sleep. The experiment was simple: 110 undergraduates were randomly divided into two groups. The first group was told to fall asleep “whenever you want,” while the second group was instructed to fall asleep “as fast as you can.” To make matters more interesting, the scientists also varied the background music, with some students falling asleep to a loud John Phillip Sousa march and others drifting off to “sleep-conducive new age music.”

Here’s where the data gets interesting: subjects who were instructed to fall asleep quickly took far longer to fall asleep, at least while listening to Sousa’s marching music. Because they became anxious about being able to fall asleep to the upbeat tune, all of their effort backfired, so that they would lie awake in frustration. Instead of just letting themselves drift off into dreamland, they kept on checking to see if they were still awake, and that quick mental check woke them up.

Wegner and colleagues suggest that this paradoxical thought process can explain a large amount of chronic insomnia, which occurs after we get anxious about not achieving our goal. The end result is a downward spiral, in which our worry makes it harder to pass out, which only leads to more worry, and more ironic frustration. I wake myself up because I’m trying too hard to fall asleep.

One of the paradoxical implications of this research is that reading this article probably made your insomnia worse. So did that Ambien advertisement on television, or the brief conversation you had with a friend about lying awake in bed, or that newspaper article about the mental benefits of R.E.M. sleep. Because insomnia is triggered, at least in part, by anxiety about insomnia, the worst thing we can do is think about not being able to sleep; the diagnosis exacerbates the disease. And that’s why this frustrating condition will never have a perfect medical cure. Insomnia is ultimately a side-effect of our consciousness, the price we pay for being so incessantly self-aware. It is, perhaps, the quintessential human frailty, a reminder that the Promethean talent of the human mind — this strange ability to think about itself — is both a blessing and a burden.

This is quite right. As a previous confirmed insomniac, many years ago, it was the worry about how tired I was going to be the next morning that kept me awake for hours. Nothing is more aggravating to insomnia than anxiety.

There is a trick, however, to get out of all of it. But first, you have to see the brain’s operation as like the route to a particular destination. When you first take it the route is unfamiliar and inconsequential. But when you take it again (and subsequently) memory comes into play and the route becomes imbedded into your memory banks. You don’t have to consciously think about it for the route itself becomes familiar in memory, and you can replay it in your mind if you wish.

Thought operates in the same way. A single thought – about a white bear – is meaningless and would have no effect on your mind. However, when you resolve not to think of it, that very thought reinforces the original thought and it becomes imbedded. This is memory in operation – just like the familiar route mentioned.

Once memorised in this way it becomes part of the physical structure of the neural pathways of the brain – and all subsequent thought about it cements it even deeper. So the thought pathway compounds on itself.

The trick is to regard all thought as fleeting, repetitive and meaningless, especially all thoughts one has lying in bed. It is just the mind at work, all the time – hence dreams. So, when you let the thoughts go, never focussing on any one of them, you will see they have no affect on your mind (this is of course the principle behind mindfulness meditation). Just watch the thoughts, but never concentrate on any of them; they have no intrinsic significance. Only the thoughts you think about – which again is a meaningless activity – become imbedded and cause subsequent problems.

The deeper aspect of all this is the self-identification of thought: these are my thoughts. If you learn to see thoughts as simply thought – not mine or yours – but just the normal activity of the mind/brain, you can see them all as transient and let go of them. This is freeing the mind.
(Needless to say, I never suffer from insomnia now.)

In general, I think your theory is correct. I suffer from the entire syndrome that you describe. But I think your article includes one important incorrect correction. When like me, you wake up shortly after falling asleep (perhaps after a troubling dream), I believe strongly that something other than what you are talking about wakes you up although I don’t what it is.

jonah, just discovered you after reading your depression article in the times which i forwarded to about 10 people in my depression/bipolar support group. we are also poor sleepers so i sent them this blog too. now we all have our own insomnia support group tonite. the amazing thing about staying up at nite when we want to sleep is, as mentioned, it’s so darn boring. why, for example, can’t i do the work i’d normally do during the day? there’s something about the nite….mysterious, dark sided, my soul stunted.

It’s worst when you have been driving. When driving, your brain thrusts you back to alertness as soon as it registers you slipping towards sleep..so once you’re home and in bed, it can’t switch that safety feature off..as soon as you start to drift it pulls you awake to check nothing bad is about to happen.. if i drive late at night i can’t attempt to go to sleep for ages afterwards. I think it’s possible people who are poor sleepers/struggle to get to sleep or stay that way, are tired during the day and spend a lot of their time fighting to stay awake (albeit not always conscious of that fact) so this programs their brain to think of that ‘falling asleep’ moment as a problem..so i would suggest people avoiding any situation where they have to stay awake.
However i know of two ways of trying to get to sleep that both work well for me. One is counting backwards, i don’t know why this works: try counting backwards down from 1000. If you mess up, start again. I can’t ever get beyond about 700 and something.. Method 2 – pretend you are a baby. stop thinking about sleeping and think about being a baby. Think about what your pram blanket felt like or other things to make it feel as real as possible..if you get this right you will notice that your breathing has moved from adult rib-breathing to lovely baby belly breathing..it’s much easier to get to sleep from this state, but don’t think about sleep, think about being a baby. If this version doesn’t work for you and you can’t imagine it well enough, just remember your brain and body both need sleep. It’s fine for your body to catch some while your brains awake. Instead of lying there fidgetting because your brains awake, just work on sending your body to sleep. Start at your feet and work up til your all asleep expect your head. Then you can lie there and think all you like, but your body will be getting rest. generally i find once i get to that stage, it’s not so long before my head joins in.

Why is self awareness always associated with the contents of thought? What about awareness of body sensations that occur prior to the interpretation of a busy mind?

What happens in the brain when one shifts focus to pure bodily sensation, like feeling the weight of your body on the bed, or sensing the texture of the sheets on your skin? I think a study on something like this would reveal some fascinating information.

I’ve met a number of insomniacs who have used body centered awareness techniques to either greatly alleviate or entirely overcome their insomnia.

I’m not sure how much blame for insomnia I’d place on the software portions of your brain rather than the hardware. I suppose that sleep may be difficult because you are “thinking about it wrong”, but it seems to me that if the underlying physical sleep mechanisms dictate that it’s time or not time for sleep, it’s going to happen or not happen – often in spite of one’s conscious efforts otherwise.

In Steven Strogatz’s (also a NY Times contributor) book Sync, he describes in the chapter “Sleep and the Daily Struggle for Sync” many extensive sleep studies and what they showed about the very complex interactions of different body cycles interacting with the external day/night cycle, all in the greater context of the book: how individual cyclic operators can fall into sync with others to produce group order from otherwise chaos. What impressed me about this in the context of sleep is how complex and sensitive the various body cycles are to external cues as they try to achieve synchrony with them, and the timescale involved in trying to establish this sync. For example, in one sleep experiment a subject who was unknowingly forced to follow a 23.5 hour day developed bad insomnia and a very poor emotional attitude throughout his waking period; in other experiments the number of days for sleep sync/de-synchronization to occur was more on the order of weeks than a day or two. Thus good sleep comes as a result of a delicate and complex synchronization of subtle internal and external oscillators that can take several weeks to fully develop.

I’ve suffered from insomnia in the past too, but seem to be able to resolve it by going to bed and waking up (to plenty of light) at precisely the same time each day, 7 days a week. (Which can be quite an accomplishment for many people’s schedules, I know.) I wonder how many of the other insomniacs here are simply far out of sync due to chaotic sleep schedules and unnatural light levels throughout the 24-hour day.

The trick is never to obsess: when in bed: be body not brain
(but don’t try to hard
Interesting remark by Philip Parsons, about insomniacs being out of sinc due to light-pollution and chaotic sleep schedules

I see many cases of insomnia in my practice, and most of them involve this “ironic” mental process. The best treatment for this mental process is applying a little Buddhist philosophy, and the opposite type of mental process “paradoxical relaxation”.

As long as someone thinks “I have to/need to/must fall asleep” they are not going to fall asleep easily because they are trying to motivate themselves to sleep with fearful threats.

“Have to/need to/must” are all of the “stick” variety of motivation (as opposed to the “carrot”) and they are all implicitly threatening “or else…”. Since “Or else…” is the next stop on this train of thought, these words provoke catastrophizing about the horrors of not sleeping and having to face all the events of the following day with little or no sleep.

This thought provokes fear, releasing cortisol and epinephrine into the blood, making the heart beat faster and the mind more altert. Then comes the frustration and resentment toward oneself for being completely awake! Muscle tension restricts deep breathing, and the illusion of a self/other struggle between modules of the brain calls for even more adrenal stimulation.

How are you supposed to fall asleep when you’re affraid? It’s like putting a gun to someone’s head and ask them to fall asleep. How successful do you think that would be?

The better way to ease yourself to sleep is to use the carrot: “I’d like to sleep” This train of thought simply implies “wouldn’t that be nice?”; it doesn’t link to the catastrophizing neural networks that prevent us from sleeping.

We don’t “have to” do anything. Everything is a choice. Even if someone puts a gun to your head, you don’t “have to” give him the money. You could choose to resist, as some people do, or you could choose to give what you have, or you could choose something in-between like negotiating to keep your sim card, or not telling him about the wad of cash in your coat pocket, etc.

If you think proactively, everything is a choice based on preferences. If you think reactively, everything is an obligation based on fears. Neither one represents reality, they are simply was of relating to reality.

The first way of thinking, using the “carrot” or approach-behavior of the left pre-frontal cortex (the area that lit up most on the fMRI of those Buddhist monks in meditation) is a lighter way of going about things. Who needs fear?

But an even better way to get to sleep is to use the equanimity of mindfulness. A practice that I teach to my patients, which they practice as the acupuncture needles rebalance their autonomic nervous system away from the “fight or flight” of sympathetic stimulation, and toward the “rest and digest” of a healthy parasympathetic tone.

You can’t “force” yourself to sleep, but you can get out of your own way and “let” yourself sleep.

When I recently couldn’t sleep, or concentrate at work, because of some stressful obsessive thoughts, I discovered a trick that helped me out: imagine the thoughts playing out on a small-screen TV. Normally my thoughts fill an “IMAX” screen that fills my whole attention. By re-imagining the same thoughts onto a small screen it gives some mental distance from and space around the emotions and obsession of the thoughts. It makes them less personal and easier to set aside since they are no longer dominating my attention.

Lol; yeah, I’m going to obsess over not obsessing. That’ll help.
Some of what others have described fits exactly what my experience has been. It’s not just the tiredness – you’d think that you could make some productive use of the time if you’re going to be awake till 2, 3, 4am. But the quality of your mental focus is crap. I bet if you had any mental focus, you could probably go to sleep anyway.

Often, I’ll fall into an easy cycle of wakefulness/sleepiness as a seasonal thing, and moving into the autumn and winter, that’s disrupted, (definitely most sharply at the DST changeover!) – and may return in fits and starts – a few days in a row, a few weeks, but not really until late June. Seems when I let the sun get up first, I’m much better off; in general.

I’ve tried hot baths, reading, exercise on various schedules (time permitting), I *do* believe in the pop-science belief that watching TV (or computer screens) within 30-minutes of bedtime makes it worse. (my personal theory is high-frequency optical stimulation keeps the neurons over-stimulated, but that’s very much a layman’s opinion). Ultimately, the only thing that has been effective so far, is mild prescription anti-anxiety medication. In a few years, I’ll be more at-liberty to let the sun rise before me, year-round. We’ll see how that goes.

I’m certain that if I lived North of the Arctic Circle, I would long ago gone mad.

Daniel, I agree with your mindfulness solution. Thinking too much was solved by Buddhism and meditation a long time ago. Matthiue Ricard’s new book on Mediation is excellent for those wanting to know more (rather than obsessing more about insomnia itself which is of course self-defeating). He’s undergone personally a lot of scientific experiments to learn more about how his brain has changed. This is a good interview with him in the New Scientist recently:http://www.newscientist.com/article/mg20527455.900-matthieu-ricard-meditate-yourself-better.html

Dude, it’s easy: get exercise, get sunshine. When you can’t sleep, start doing all the things you’ve put off doing for the last month. Clean out your desk. Wash the floor. If that doesn’t work, start reading a worthy but heavy book – the one you’ve been meaning to read because it’s good for your soul – but it’s just so dang boring that you couldn’t get started. Still awake?? Start learning a new language. Pick one that’s tough – Mandarin is the world’s toughest language to learn if it’s not your native tongue. Still awake? Well, at least you’re more organized, educated, and ready for foreign travel.

It just occurred to me how similar this is to performance anxiety… sexual or sports related for example. We can become so worried about performing that the anxiety overrides the ability to complete the act.

My insomnia occurs in waves and I deal with it by drinking herbal teas such as Chamomile or Valerian, etc. I also try not to get out of bed. I simply turn the light back on and continue reading something until I am tired again, and sometimes repeat that cycle several times. Quiet jazz music seems to help.

No TV in the bedroom? TV is my electronic valium. I find something really mellow-verging-on-boring or strange as this may seem – very absorbing. The former (think HGTV programs – instant snooze) just lulls me into a coma. The latter keeps my mind off my own problems. It is when I wake up at 3 a.m. and my brain starts going warp speed on every problem I have, have ever had, or will ever have that I can’t sleep. If I block those brain cells with TV drivel, it stops the cyclone of stressful thought and I drift right back to sleep. That “doink doink” (come on, you know exactly what I mean, admit it!) can put me to sleep instantaneously.

I suffer from bouts of insomnia, and once had an Eastern med doctor tell me that I needed to learn how to think with my brain, not with my body. My brain can work all night, but the body needs rest. This is contrary to what I’ve read about memory and whatnot, that the brain needs the off-time to recompartmentalize what has happened during the day, to discard the unimportant and retain the significant. But I suppose that is the brain doing something as well, so perhaps the brain does indeed work all night?

Several years ago, after consistent success and high functioning, I experienced depression that cost me a year of my life. During that period, I literally could not do anything. To suggest that depression and rumination aid creativity and personal problem solving is fantasy that arises from not having personally experienced this terrifying and debilitating illness.

I got my life back due only to a combination of meds prescribed by an expert psychopharmacologist. It would have been impossible for me to use my condition in the positive ways suggested by your article. I had no will.

After regaining my life, I was motivated to make changes in terms of priorities and dealing with worry and stress. This resulted from what amounted to a near death experience and my fear of slipping back, not from having been given a time out from life and the chance for constructive rumination.

The speculations of the doctors featured in your article, as well as it’s tone, are a disservice to those who actually experience mental illness and may already be reluctant to take advantage of the tremendous advances made in the mental health field in the past twenty years.

The answer to this problem is to quit worrying about sleep. If you’re awake lying in bed thinking, go do what you’re thinking about. You won’t die from lack of sleep. If you make yourself wake up, you’ll eventually fall asleep, and you won’t worry about the wasted time you spent lying awake.

1. Focus on the “light” snippets the brain gives you when your eyes are closed, try to amplify them, let them evolve into images as the brain creates explanations for what it is focusing on.

2. Thought in sleep is illogical, this and the next trick aim at disconnecting from a logical consciousness. Simply think a stream of random words or nonsense syllables and keep at it until you drift off.

These work for me, most of the time. They work better as someone suggested, combined with a sense of, “I enjoy sleeping” rather than, “I am fighting insomnia”.

The other point is that I tend to experience myself as awake and engaged in trying to sleep at times when my wife assures me I am snoring. I have a vague memory that some sleep lab studies have indicated that some insomniacs over estimate the amount of time they are awake, no reference alas. One of the nice things about this is that I can downgrade the importance of insomnia, “yes I think I am trying to get to sleep but I may well be already asleep!” So insomnia becomes less anxiety inducing.

GHB. Normalizes sleep architecture. Allows you to choose when you want to sleep, and to wake up energized..

Major disinformation campaign demonized this naturally occurring substance. Thank god I had it as an Rx when my kid was growing up so I could parent and participate. I took it at time of choice, usually 11. Out in 5 minutes and up at 7.

Now, 2 or 3 am is normal. My life revolves around the insomnia. I want normal, but nanny state gave in to pharmcos on this one. GHB also was used for the anxious and depressed and stopped suicidal ideation in 30 minutes. That would destroy half of the billions raked in every year from massive drug sales for these issues.

Reminds me of a sci-fi novel I read once where humans had achieved minute control over their bodies. Adrenaline, endorphin, melatonin – all these things were effectively ‘on tap’ with conscious thought.

The insomniacs were still insomniacs, though, because they couldn’t pull the internal trigger that would will melatonin into their system.

I have always counted down from 200. Lay with your eyes closed and make a mental image of each number… If you find your mind wandering, just pick up from the last number you remember counting. This works for me when I need to sleep.

seroquel is a wonderful drug for insomnia – no “buzz” like ambien or xanax / klonopin etc. and no hangover. some people complain about an increase appetite but that hasn’t happened to me. i know taking any drug for sleep has its downsides and is in principle “less good” than learning to sleep without any chemical aid, but it’s literally saved my life. my insomnia was so bad, so “embedded” that i would go weeks and weeks without sleeping more that an hour a night, that while doing everything possible to encourage sleep – exercise, no caffeine, no computer, etc. etc.

Do you always fall asleep with a book? Perhaps it is not comfortable and your bodily adjustments after dozing off awaken you. I struggled with insomnia two times in my life…. I used to think there was a certain biochemical that was released very soon after nodding off. I thought if something caused a person to wake(discomfort or adjusting body movements) shortly after falling asleep, and that person was not in a deep enough sleep, it caused the problem. I surmised that an active mind would have had it’s chemical fix for a time and, thus, greatly hinder the biochemical need to fall to sleep again for a time. Don’t laugh, but I used to guess at that. I have had insomnia for a year or so at two times during my life. I’ll admit the pattern of it eventually caused me to fear it and definitely prolonged the problem, as detailed in your blog. I never wanted to try meds of any sort to solve it; it eventually resolved. I greatly avoid scenarios (uncomfortable clothes, books, postions, any factor…)that might awaken me soon after I initially fall to sleep.
I train very hard to race my bicycle, so I can not afford to lose sleep on a regular basis…

I’m struck that so many of the insomnia solutions posted in the comments here are mental activities or systems that themselves participate in the “white bear” problem. You count backwards, or even meditate, and you are engaging in a discipline with a goal: falling asleep. Unfortunately, having this goal is the very thing that prevents you from achieving the goal.

At the end of his article Lehrer states that being aware of this paradox ironically makes the situation worse. I would disagree, and say that being aware of the paradox gives one the insight to “give up,” as it were. If trying to sleep is what prevents you from sleeping: don’t try.

As a mild insomniac myself, I found that my insomnia got a little better, or at least stopped being a problem, when I realized that there was nothing I could “do” about it, that “doing” was only contributing to my wakefulness. Now if I can’t fall asleep, I tend to think: “oh well, I might not sleep all night, but that’s okay, there’s nothing I can do about it.” That’s not some self-reverse-psychology trick; I think that because it’s true.

This fatalistic acceptance of insomnia doesn’t always make me fall asleep, but it does stop me worrying about it. Then I can spend the time thinking about something else. Sometimes I’ll concentrate on something from work that needs some thought, and try to keep focused on it; that way my insomniac time is contributing to my next day (and nothing puts me to sleep faster than trying to focus on something other than sleep).

I’m a little bit confused about why, in the study, they are attributing the longer time to getting to sleep to the instructions rather than the marching music. That seems like too many confounding issues.

Insomnia, the bane of a modern person’s existence. More and more people suffer from this condition. Sometimes, it is triggered by daily wake and sleep pattern. Sometimes, it can be caused by illnesses. In many cases, it can be caused by sleeping on a very uncomfortable mattress. This is why the bed is the most important piece of furniture in the bedroom. Make sure that you are getting a mattress that can really solve body problems as you sleep so you can get rid of insomnia.

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